SAVE YOUR KNEES

1. I.M. Doctor, M.D. My Office My City, State SAVE YOUR KNEES

2. The information in this presentation was provided to the presenter by the American Academy of Orthopaedic Surgeons and may be modified. Endorsement of this presentation by the AAOS is not implied or inferred.

3. Save Your Knees • Orthopaedics and the Bone and Joint Decade • Protecting your knees

4. What is an orthopaedic surgeon? • MD who specializes in treatment and health maintenance of musculoskeletal system (bones, joints, ligaments, muscles, tendons, cartilage and spine)

5. What is an orthopaedic surgeon? • The expert in maintaining musculoskeletal health • The expert in treating the musculoskeletal system

6. Educating an Orthopaedic Surgeon • College • Medical School • Internship • Orthopaedic Residency • Fellowship (optional) • 2 Years Practice TOTAL 4 4 1 4 (1) 2 16 years!

7. What do orthopaedic surgeons do? • Diagnose • Treat • Medication • Physical Therapy • Exercise • Brace • Surgery • Prevent

8. Save Your Knees Your Orthopaedic Surgeon Getting You Back In The Game

9. Save Your Knees

10. The Knee Joint

11. The Knee Joint © 2009 Getty Images

12. Pain or damage often caused by: Injuries Osteoarthritis The Knee Joint

13. Save Your Knees

14. Knee Injuries • Sprains • Ligament (ACL, PCL, MCL, LCL) tears • Meniscus tear Illustration reproduced with permission from The Body Almanac, American Academy of Orthopaedic Surgeons, 2003

15. Ligament injury Knee pain, tenderness, swelling Knee Injuries: Sprains

16. Knee Injuries: Sprains • R.I.C.E.: rest, ice, compression, elevation • Rehabilitation • Anti-inflammatory • Brace

17. Direct blow to knee Non-contact injury, with foot plant Landing on straight leg Making abrupt stops Knee Injuries: Ligament Tear

18. Knee Injuries: ACL Tear Normal anatomy Hyperextension Anterior cruciate ligament Femur Femur slips Anterior cruciate ligament tears Patella Tibia Fibula Illustration reproduced with permission from The Body Almanac, Rosemont, IL American Academy of Orthopaedic Surgeons, 2003

19. Knee Injuries: ACL Tear • Incidence of ACL much higher among female athletes • Combination of causal factors

20. Knee Injuries: Meniscus Tear • Helps knee joint carry weight, glide, and turn • Twisting injury • Football and other contact sports

21. Knee Injuries: Meniscus Tear • Pain • Giving way • Locking • Clicking • Swelling

22. Inability or decreased ability to play Locking, popping, catching Visible deformity Severe pain or giving way When to See the Doctor

23. Nearly 21 million Americans age 25 and older have osteoarthritis 46 million U.S. adults report doctor-diagnosed arthritis As the U.S. population ages, these numbers are likely to increase dramatically. The number of people who have doctor-diagnosed arthritis is projected to increase to 67 million in 2030. Knee Pain: Osteoarthritis

24. Knee Pain: Osteoarthritis Inflammation Avoidance of Motion Loss of Motion Increased Muscle Tightness

25. Knee Pain: Osteoarthritis Cartilage © 2009 Getty Images © 2009 Getty Images Healthy Knee Osteoarthritic Knee

26. Primary Osteoarthritis: Most Common Thought to be result of aging Decreased ability of cartilage to repair itself Ligaments supporting joints weaken Osteoarthritis Causes

27. Secondary Osteoarthritis Obesity Trauma Surgery Abnormal joints Gout Diabetes Hormone disorders Osteoarthritis Causes

28. Treatment

29. Treatment Drug therapy Intra-articular treatment Surgery Experimental/alternative treatments Health and behavior modifications

30. NSAIDs are non-steroidal anti-inflammatory drugs Aspirin Ibuprofen Naproxen Treatment: Medication

31. Vitamins & Nutritional Supplements

32. Why? Alternatives Benefits and for how long? Treatment: Surgery

33. Treatment: Surgery • Duration of recovery? • Assistance at home? How long? • Disability after surgery? • Physical therapy? • Return to normal activity?

34. Arthroscopy Surgical abrasion of cartilage Treatment: Surgery

35. Treatment: Surgery Pre-Osteotomy Post-Osteotomy

36. Surgery: Total Joint Replacement

37. Know and abide by rules Wear appropriate protective gear Know how to use equipment Never “play through pain” Preventing Sports Injuries

38. Prevention: Exercise

39. Strengthening exercises can help Correct positioning is critical Prevention: Exercise

40. Strengthening exercises can help Correct positioning is critical Prevention: Exercise 40

41. Marching Walk in place Jumping jacks Mimic the sport you are about to do Prevention: Warm Up Warm- up:

42. You should NOT feel pain Hold stretch 30 seconds Relax into the stretch Prevention: Stretching Stretching:

43. Prevention: Stretching Breathe deeply & slowly Avoid bouncing Stretch both right & left sides

44. DO: Include flexibility, strengthening, and aerobic exercises Exercise when you are not tired Exercise when pain and stiffness lowest Exercise when medication having greatest effect Prevention: Exercise

45. DO: Always warm-up and cool down Start slowly, progress gradually Avoid becoming chilled or overheated when exercising Use heat, cold, & other pain reducers Prevention: Exercise

46. DO: Use aids like walking sticks, braces, or canes if recommended Expect minor discomfort Use two-hour rule: No more pain two hours after exercising than before you started Prevention: Exercise

47. Talk to your physician first Consider athletic trainer or physical therapist Prevention: Exercise

48. DON’T: Do too much too soon Hold your breath while exercising Take extra medication before unless your physician suggests it Prevention: Exercise

49. Consult your physician if these symptoms are present: Unusual or persistent fatigue Increased weakness Decreased range of motion Increased joint swelling Continued pain 1 hour after exercising Too Much Exercise

50. Resources American Academy of Orthopaedic Surgeons 6300 North River Road Rosemont, IL 60018 orthoinfo.org saveyourknees.org arthritis.org